AB0748 COGNITIVE FUNCTION IN POLYMYALGIA RHEUMATICA AND GIANT CELL ARTERITIS
Authors: P. Harkins, S. Cowley, D. Kane, R. Conway
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> In the past decade our understanding of the prevalence, and indeed impact of cognitive impairment in rheumatic diseases has increased.[1, 2] An aging population, coupled with systemic inflammation have been postulated as key drivers of increased cognitive decline in these conditions. Intact cognitive function is imperative not only for quality of life and maintenance of one's functional capacity, but also for the successful therapeutic management of disease, namely the adherence to treatment regimens. Both giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) occur in those over 50 years of age, and are associated with a significant systemic inflammatory response. [3] To date, the prevalence of cognitive impairment in these conditions has not been studied. <h3>Objectives</h3> To explore the prevalence and possible predictors of cognitive impairment in those with PMR and/or GCA. <h3>Methods</h3> Participants from a multicentre longitudinal cohort study of PMR and/or GCA participated in a study visit that included an assessment of cognitive function. Cognitive function was evaluated using the Montreal Cognitive Assessment (MoCA) test which was conducted by trained interviewers. Demographics, clinical and laboratory data related to disease activity (PMR-Activity Score), neuropsychiatric symptoms (DASS-21) and patient reported outcomes (Visual analogue scale (VAS) and health assessment questionnaire (HAQ-DI)) were collected. Cognitive impairment was defined by the previously validated MoCA cut-off score of &lt;26. A two tailed t-test, and independent chi squared test were used to analyse continuous and categorical variables respectively. A multivariable linear regression analysis was then performed. <h3>Results</h3> A total of 55 participants with a mean age of 70.5 (SD 7.61) were suitable for inclusion. 29 (52.7%) were female. 29 (52.7%) had isolated PMR, 8 (14.5%) had subclinical GCA with PMR, and 18 (32%) had isolated GCA. 34 (61.8%) participants were cognitively impaired, with executive skills, verbal fluency and abstraction the most affected domains. Advancing age demonstrated a statistically significant association with cognitive impairment (OR 1.12, 95% CI 1.016- 1.233, p&lt;0.05). Notably, our analyses did not show a statistically significant association between cognitive performance and gender, BMI, functional limitation, VAS scores, neuropsychiatric symptoms, serum interleukin-6 levels or disease activity scores. Moreover, there was no statistically significant increased risk of cognitive impairment in those with GCA/ subclinical GCA versus those with isolated PMR. <h3>Conclusion</h3> The findings of our study show for the first time that the prevalence of cognitive impairment in those with PMR and/or GCA is significant. We highlight the need to address cognitive health in those with PMR and/or GCA, both in clinical settings and also future large scale research. <h3>References</h3> [1]Pankowski D, Wytrychiewicz-Pankowska K, Janowski K, Pisula E: <b>Cognitive impairment in patients with rheumatoid arthritis: A systematic review and meta-analysis</b>. <i>Joint bone spine</i> 2022, <b>89</b>(3):105298. [2]Al Rayes H, Tani C, Kwan A, Marzouk S, Colosimo K, Medina-Rosas J, Mustafa A, Su J, Lambiris P, Mosca M: <b>What is the prevalence of cognitive impairment in lupus and which instruments are used to measure it? A systematic review and meta-analysis</b>. In: <i>Seminars in arthritis and rheumatism: 2018</i>: Elsevier; 2018: 240-255. [3]Buttgereit F, Dejaco C, Matteson EL, Dasgupta B: <b>Polymyalgia rheumatica and giant cell arteritis: a systematic review</b>. <i>Jama</i> 2016, <b>315</b>(22):2442-2458. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Patricia Harkins Grant/research support from: Janssen Pharmaceuticals., Sharon Cowley: None declared, David Kane: None declared, Richard Conway: None declared.